1. Given the fact that I have tested negative for all testable std. Is this something that can harm my wife?

2. My wife and I took doxycycline when I was dx. Would this have protected her from any harmful non std bacteria. 

3. I have read numerous posts saying that ngu from oral sex is typically harmless and viewed as an inconvenience. Is this science based or just from general clinical experience?

4. I am worried that my wife could contract pid from my stupidness. Is that a concern? She has missed 2 periods and is not pregnant. 

As you can probably tell. I am having a hard time dealing with this. It is eating me up emotionally and physically. 

Thank you for your time and patience 

Thank you. Sincerely. You provide a great service to idiots like me.  

1,4) Since you have no STD or other infection that explains your symptoms, you have nothing that can harm your wife. There is no STD known to cause missed menstrual periods -- and congratulations on your wife's pregnancy.

2) For the same reasons, there was no reason for your wife to have received doxycycline. But if you indeed had had NGU, it would have been the standard treatment for her and would have protected her from harm.

3) I have never said definitively that NGU from oral sex is harmless, only that this seems to be the case. There have never been any systematic studies of it. However, I do not recall ever seeing the partner of a man with such NGU who seemed to have any significant medical problem from it, and this also seems to be the consensus of all other STD experts. In fact, NGU in general, whether orally acquired or not, seems to be associated with rare if any apparent harm in female partners, unless due to chlamydia and maybe Mycoplasma genitalium. In any case, as I have said repeatedly, you never had symptoms that suggest NGU anyway.

It is very common to identify various intestinal or genital tract bacteria in semen or the urethra. That's what E. fecalis is, a garden variety bacteria found in everybody's rectum and/or genital tract. Absence of white blood cells is further evidence it isn't doing any harm, and I doubt it even exists in your semen per se; it is much more likely a contaminant from your penile skin or the urethral opening. I would ignore it entirely -- but if you remain concerned about it, ask the doctor who ordered the semen culture.

Finally, in response to "I am having a hard time dealing with this. It is eating me up emotionally and physically", all I can say is I and this forum have done all we can. We give the facts and probabilties as best we understand them. The rest is up to you. However, I would also point out that it is not normal to be so resistant to the repeated, reasoned, science-based reassurance you have had. It seems clear you are continuing to react emotionally to a sexual decision you regret. If those fears continue despite this additional reply, your next step should be professional counseling to help you move on. I suggest it from compassion, not criticism.

Good luck and congratulations on your coming fatherhood!  HHH, MD

Thank you for your time. I will not follow up with any further questions unless visit to urologist throws further spanners in the works.

If you would indulge me.  I would like to ask a few more questions. 

1. I still have a little puffiness and redness of my meatus. It settles down a lot if I apply canisten hc cream to it.  Is this indicative of an std or more of yeast/thrush?

2. When I ejaculate. If i am not scrupulous with hygiene afterwards, the meatus will often be very red and puffy and urethra will itch slightly inside. What causes this. It's not something new to me as I have noticed this for many years but it is more pronounced since the onset of my symptoms  

3. It been over a year now. I know you have said that this is not ngu but if somehow it was, would the 6weeks of cipro, the doxy and azithromycin took care of it and would it have run its course naturally ? As you can probably tell, I am extremely worried as I have so much to lose. 

Finally. I know the dialog is closed after 2 responses but I was hopeful that you would leave it open so I can report back after the course of augmentin. I don't want or expect you to answer any subsequent questions after this one. It will only for the benefit of other people who may read our interaction. 

Many thanks Dr. All the best 

Ampicillin, amoxicillin and Augmentin:  Your doctor is exactly right. Amoxicillin is a minor chemical change from ampicillin, which is used in the lab to test bacterial susceptibility to amoxicillin. Augmentin is amoxicillin plus clavulanic acid, which makes the drug more effective against some bacteria. It doesn't have that particular benefit against enterococcus, but is marketed in a larger dose, allowing twice daily instead of 3-4X daily dosing. The expanded bacterial coverage also might benefit other bacteria that can contribute to prostate and other internal urinary tract infections, but which might have not shown up on the culture. It will be just as effective as amoxicillin or ampicillin would be, and is exactly what I would prescribe in this situation.

1) It isn't possible to judge this given the response to Canestin HC. The HC stands for hydrocortisone, which reduces inflammation of any cause. If you try plain Canestin (without the HC) and the symptoms still respond, it would favor a yeast infection. In any case, this sounds harmless and nothing to worry about. In any case, this is best discussed with your urologist.

2) I can't say why these symptoms might happen. It's not an STD issue and not something I've ever dealt with in my own patients. Your urologist is in a better position to answer this.

3) The new information doesn't change my opinion or advice about NGU or STDs. For sure this is not NGU and never was. You need to work on your obsession about it. Not all genital problems are STDs or related to sexual behavior and exposures.

Thanks for the thanks and for your kind comments about our services. But since this isn't an STD and hence off topic for this forum, I'm going to ask that you not post any more questions about this situation. Best of luck for speedy recovery.